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When To See a Doctor for a Sprain or a Strain? (NIAMS)



-You have severe pain and cannot put any weight on the injured joint.

-The injured area looks crooked or has lumps and bumps (other than swelling) that you do not see on the uninjured joint.

-You cannot move the injured joint.

-You cannot walk more than four steps without significant pain.

-Your limb buckles or gives way when you try to use the joint.

-You have numbness in any part of the injured area.

-You see redness or red streaks spreading out from the injury.

-You injure an area that has been injured several times before.

-You have pain, swelling, or redness over a bony part of your foot.

-You are in doubt about the seriousness of the injury or how to care for it.

A grade II or moderate sprain is caused by further, but still incomplete, tearing of the ligament and is characterized by bruising, moderate pain, and swelling. A person with a moderate sprain usually has more difficulty putting weight on the affected joint and experiences some loss of function. An x ray may be needed to help the health care provider determine if a fracture is causing the pain and swelling. Magnetic resonance imaging is occasionally used to help differentiate between a significant partial injury and a complete tear in a ligament, or can be recommended to rule out other injuries.

People who sustain a grade III or severe sprain completely tear or rupture a ligament. Pain, swelling, and bruising are usually severe, and the patient is unable to put weight on the joint. An x ray is usually taken to rule out a broken bone. When diagnosing any sprain, the provider will ask the patient to explain how the injury happened. He or she will examine the affected area and check its stability and its ability to move and bear weight.

What Causes a Strain?

A strain is caused by twisting or pulling a muscle or tendon. Strains can be acute or chronic. An acute strain is associated with a recent trauma or injury; it also can occur after improperly lifting heavy objects or overstressing the muscles. Chronic strains are usually the result of overuse: prolonged, repetitive movement of the muscles and tendons.

Where Do Strains Usually Occur?

Two common sites for a strain are the back and the hamstring muscle (located in the back of the thigh). Contact sports such as soccer, football, hockey, boxing, and wrestling put people at risk for strains. Gymnastics, tennis, rowing, golf, and other sports that require extensive gripping can increase the risk of hand and forearm strains. Elbow strains sometimes occur in people who participate in racquet sports, throwing, and contact sports.

What Are the Signs and Symptoms of a Strain?

Typically, people with a strain experience pain, limited motion, muscle spasms, and possibly muscle weakness. They can also have localized swelling, cramping, or inflammation and, with a minor or moderate strain, usually some loss of muscle function. Patients typically have pain in the injured area and general weakness of the muscle when they attempt to move it. Severe strains that partially or completely tear the muscle or tendon are often very painful and disabling.

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
301-495-4484 or
877-22-NIAMS (226-4267) (free of charge)
Fax: 301-718-6366
TTY: 301-565-2966
www.niams.nih.gov

The National Institute of Arthritis and Musculoskeletal and Skin Diseases provides information about bone, muscle, and joint diseases; arthritis and rheumatic diseases; and various forms of skin diseases. It distributes patient and professional education materials and refers people to other sources of information. Additional information and updates can also be found on the NIAMS Web site.





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Posted on 19 Nov 2006 by coachgianni
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